拮抗失行を初発症状とした脳梁astrocytomaの1例

A Case of Astrocytoma of Corpus Callosum Presented Diagonistic Dyspraxia

　拮抗失行を初発症状とした脳梁astrocytomaの1例を経験した。症例は38歳男性。右手の動きに触発された左手の異常行動を呈し，その後，頭痛，めまいが出現，増強したため当科を受診した。初診時には左手の異常行動，脳梁離断症状は認めず，前頭葉機能検査で軽度の低下を認めた。CT, MRIでは脳梁膝部から体部と両側前頭葉内側に腫瘍陰影を認め，開頭術によるbiopsyを行った。病理組織診断はfibrillary astrocytomaであった。放射線療法および化学療法を行った後，明らかな神経脱落症状なく退院，社会復帰した。過去の拮抗失行例と責任病巣は一致していたが，過去の報告例はほとんどが脳血管障害例であり，脳腫瘍例での報告は本例が最初のものである。

A case of astrocytoma whose first clinical presen-tation was diagonistic dyspraxia was reported. A 38-year-old right-handed male experienced funny motion of his left hand triggered by voluntary movement of his right hand. One day, he tried to insert a coin into the vending machine with his right hand, then the left hand was against the other. One month after that event, he experienced headache and vertigo. On admission, there were no abnormal findings on neurological examination. On neuropsy-chological examination, he was cooperative, well orientated and attentive, and there were no callosal disconnection symptoms.